4 Alternative Tests that are No Substitutes for a Mammogram

If you’re looking for alternatives to your annual mammogram, you might want to think again. According to experts at The University of Kanas Health System in Kansas City, mammography is still your best option.

Alternative tests, such as thermography, are not recommended.

A woman in the United States has a 1 in 8 risk of being diagnosed with breast cancer in her lifetime. It’s the most commonly occurring non-skin cancer in American women and the second leading cause of cancer deaths among American women of all ages.

“So, if you’re going to get screened for something, breast cancer is the one,” says Onalisa Winblad, MD, a breast radiologist at The University of Kansas Health System. “Your chance of having your life saved is significantly increased if you get screened every year.”

And the method of screening is critical. Annual mammography is the best way to catch breast cancer at the earliest stages, when it’s often curable. Breast cancer deaths are decreased by about 30% for women who get annual mammograms.

Despite this evidence, many women avoid mammograms. Some are worried about exposure to radiation, others about pain or cost. As a result, a number of alternative breast cancer tests have received attention. Here are a few of the most popular, and why they are still no substitute for a mammogram.

When should you get a mammogram?

If you’re at high risk for breast cancer, you may need earlier, more frequent or more advanced screening. Talk with your doctor.

Thermography

Thermography uses an infrared camera to measure the patterns of heat and blood flow in the body. Proponents say it can detect cancers that cause the growth of new blood vessels, which can increase the heat generated in the affected area. Thermography appeals to women who want to avoid the radiation exposure associated with mammography, but it’s not widely accepted in the medical community as a reliable screening method.

"I’ve heard of thermography being used as a secondary or extra method of detecting breast cancer," says Dr. Winblad. "But even those claims are being questioned now. I don’t know of any breast center of excellence that offers thermography."

According to the FDA, "Thermography is not a replacement for screening mammography and should not be used by itself to diagnose breast cancer." It went on to say the FDA is not aware of any scientific data showing thermography is an effective screening tool for any condition, including breast cancer.

Ultrasound

Ultrasound uses sound waves to create images of organs and tissues inside the body. Studies have measured its effectiveness in screening for breast cancer, as well, because it doesn’t include radiation exposure. Some of those studies show it can detect cancer as well as mammography. But it has an important disadvantage: It also causes more false positives – suggesting you have cancer, when you don’t. That can result in unnecessary biopsies and a lot of extra fear and anxiety.

"While it’s not the best primary screening method," says Dr. Winblad, "we do offer ultrasound as a supplemental screening method for patients with dense breast tissue that’s harder to evaluate with standard mammography. It can detect some lesions that standard mammography will miss."

Should you be concerned about radiation?

According to Dr. Winblad, the answer is no. Radiation exposure from a single mammogram – standard or 3D – is about the same as what most people receive from natural background radiation in a week. All recognized medical societies and preventive task forces agree that the benefits of screening mammography far outweigh the risks of radiation exposure.

Breast self-exams

Multiple studies have shown that breast self-exams do not offer early detection or survival benefits like other screening methods. That means they’re not a good substitute for an annual mammogram. But it doesn’t mean you should stop doing self-exams. Most providers say you should be familiar with the way your breasts look and feel, because many women do find breast cancer on their own.

"If you detect a discharge, a new lump or skin changes, you definitely need to get checked out," says Dr. Winblad. Another note: Generalized pain and sensitivity in your breasts doesn’t suggest cancer, she says. If the pain is very concentrated and only in one breast, however, you should bring this to your doctor’s attention.

Urine and blood testing

Lab tests for vitamin D, hormone levels and other factors also have gotten some attention as potential breast cancer detection methods. But Dr. Winblad cautions against using them until they’re proven effective.

"We don’t see these tests used very often, probably because there’s still not a lot of data to support them," she says. "They may have some merit, but we can’t recommend them until we can see that they have been proven to find cancer early and reduce the death and disease rates significantly."

Is 3D mammography for you?

The University of Kansas Health System offers 3D digital screening mammograms and recommends them for all patients – not just those with dense breasts.

"We have found that 3D mammography finds more cancers than standard mammography and decreases the recall rate by 30-40%," says Dr. Winblad.

The University of Kansas Cancer Center is the only National Cancer Institute-designated cancer center in the region to offer 3D diagnostic mammography. Benefits include:

Multiple high-definition images from various angles

All images composited into a three-dimensional image for more accurate interpretation

Overlapping tissue effect seen in 2D mammograms is eliminated

50% reduction in the need for additional imaging or diagnostic procedures